HIV neurologic complications

Background

• Specific Conditions:
  • Toxoplasmosis
  • Cryptococcosis
  • AIDS Dementia
  • Progressive multifocal leukoencephalopathy
  • Primary CNS lymphoma
  • CMV neurologic disease
• Increased risk of CNS infections from other organisms
• Susceptible to same additional neuro pathology as HIV negative patients, as well

Differential Diagnosis

HIV associated conditions

• HIV neurologic complications
  • Toxoplasmosis
  • Cryptococcosis
  • AIDS Dementia
  • Seizures in patients with HIV-AIDS
  • Primary CNS lymphoma
• HIV pulmonary complications
  • Pneumocystis jirovecii pneumonia (PCP)
  • Tuberculosis (TB)
  • CMV pneumonia
• Ophthalmologic complications
  • CMV Retinitis
  • Herpes Zoster Ophthalmicus
• Other
  • AIDS fever of unknown origin
  • Immune reconstitution inflammatory syndrome
  • HIV diarrhea
  • Esophageal candidiasis
  • Kaposi's sarcoma
  • Pruritic papular eruption of HIV
  • Hairy oral leukoplakia
• HAART medication side effects
  • HAART-induced lactic acidosis
  • Neuropyschiatric effects
  • Hepatic toxicity
  • Renal toxicity
  • Steven-Johnson's
  • Cytopenias
  • GI symptoms
  • Endocrine abnormalities

Evaluation

• CT Head with out contrast
• Consider brain MRI
• LP
  • Regular studies + (India ink, viral culture, fungal culture, toxo, crypto, coccidio)

Management

• Per specific pathology